Analysis of dual task cost and brain microlesion system in parkinsonian multiple system atrophy patients

Abstract

The application discloses a kind of analysis parkinsonian multiple system atrophy patient double task cost and brain microinjury system, it is related to medical diagnosis technical field, including: gait acquisition module, for collecting the gait data of single task and double task of participant, and gait data are handled, obtain the gait characteristic data of participant;Gait analysis module is used for according to gait characteristic data, analysis participant is different in single task and double task gait and calculates double task cost;Nuclear magnetic resonance imaging module is used for collecting the nuclear magnetic resonance imaging data of participant;Morphological analysis module is used for carrying out voxel-based morphological analysis to nuclear magnetic resonance imaging data, analyzes the correlation of participant double task cost and cerebral underlay grey matter;Diffusion tensor imaging analysis module is used for carrying out diffusion tensor imaging analysis to nuclear magnetic resonance imaging data, analyzes the correlation of participant double task cost and cerebral underlay white matter.

Description

Technical Field

[0001] The present invention relates to the field of medical diagnosis technology, and more particularly to a system for analyzing dual-task costs and brain micro-lesions in patients with Parkinson's disease and multiple system atrophy. Background Art

[0002] Multiple system atrophy (MSA) is a fatal atypical parkinsonian syndrome with two main subtypes: MSA with parkinsonism (MSA-P) and MSA with cerebellar involvement (MSA-C). MSA-P presents primarily with parkinsonian symptoms and mild cerebellar manifestations, while MSA-C presents primarily with ataxia. MSA-P patients have widespread stance and inward-outward instability, and consistently fail the tandem gait test.

[0003] Using diffusion-weighted imaging, MSA-P demonstrates distinct infratentorial structural changes compared with healthy individuals and patients with Parkinson's disease (PD), including atrophy of the pons, cerebellum, and middle cerebellar peduncle, as well as increased diffusivity in the middle cerebellar peduncle. Furthermore, beyond its diagnostic utility, cerebellar white matter (WM) deficits correlate with the overall severity of MSA.

[0004] Dual-task gait involves performing additional tasks simultaneously while walking, simulating the multifaceted challenges encountered in daily life. Compared with single-task gait (STG), dual-task gait is subject to additional cognitive load, resulting in poorer gait performance. This difference is quantified as the dual-task cost. Numerous studies have investigated the impact of dual-task on gait performance in patients with Parkinson's disease and progressive supranuclear palsy. The dual-task cost is significantly higher in patients with Parkinson's disease than in healthy older adults, highlighting the utility of dual-task gait performance as a marker for distinguishing patients with Parkinson's disease from healthy controls. Furthermore, given the observed decreases in dual-task gait performance in patients with Parkinson's disease, dual-task training has been used to improve gait impairment, enhance cognitive function, and reduce adverse events during daily activities. These findings highlight the importance of dual-task gait in the diagnosis and treatment of Parkinson's disease. However, limited research has examined dual-task gait performance and dual-task cost in patients with MSA. Furthermore, the clinical application of dual-task in patients with MSA lacks a solid research foundation.

[0005] Existing research has highlighted the important role of infratentorial structures in dual-task costs in healthy individuals and patients with Parkinson's disease. Given that alterations in infratentorial structures are specific to MSA-P and distinguish them from healthy controls and other types of parkinsonism, a system for analyzing dual-task costs and brain microlesions in patients with multiple system atrophy (MSA) with parkinsonism is urgently needed to determine whether dual-task costs are also associated with infratentorial structures in MSA-P. Summary of the Invention

[0006] To overcome the shortcomings of the aforementioned prior art, the present invention discloses a system for analyzing dual-task costs and brain microlesions in patients with Multiple System Atrophy (MSA-P). This system not only identifies differences in single-task and dual-task gait between MSA-P patients and healthy controls (HCs), but also reveals the relationship between dual-task costs and infratentorial structures. This system can characterize the basic characteristics of dual-task gait performance in MSA-P patients and elucidate the underlying neural mechanisms of dual-task costs.

[0007] In order to achieve the above objectives, the present invention adopts the following technical solutions:

[0008] Analyze dual-task costs and brain micro-lesion systems in patients with multiple system atrophy (MSA) with Parkinson's disease, including:

[0009] A gait acquisition module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the participant's gait feature data;

[0010] a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data;

[0011] an MRI module for acquiring MRI data of participants;

[0012] a morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task cost and the subtentorial gray matter of the brain;

[0013] The diffusion tensor imaging analysis module is connected to the magnetic resonance imaging module and the gait analysis module, and is used to perform diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the dual-task cost of the participants and the subtentorial white matter of the brain.

[0014] 1. Gait Collection Module

[0015] Preferably, the participants include patients with multiple system atrophy (MSA) of the Parkinson's type and healthy subjects.

[0016] Preferably, the gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in single-task gait, reverse counting dual-task gait, and spontaneous animal naming dual-task gait, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the severity of the participant's disease and overall cognitive function based on the gait feature data.

[0017] Preferably, in the gait acquisition module, the single-task gait includes: the participant walks back and forth three times on a 3-meter walkway at a fixed distance from the camera;

[0018] The dual-task gait for backward counting includes: participants performing an additional task of counting backward from 100 while walking in front of a camera;

[0019] The spontaneous animal naming dual-task gait includes an additional task in which participants spontaneously name non-repeated animals while walking in front of a camera.

[0020] Preferably, in the gait acquisition module, the gait characteristic data include: swing period, double support period, stride length, step height, step frequency, step speed, stride speed, swing speed and turn duration.

[0021] The swing cycle is the period from the heel of one side touching the ground to the toe of the other side leaving the ground.

[0022] The double support cycle is the period from when one heel strikes the ground to when the other toe leaves the ground, when both legs are in contact with the ground at the same time.

[0023] Stride length is: the distance between two foot strikes;

[0024] Step height is the highest distance from the ground during foot swing;

[0025] Cadence is the frequency of your steps, calculated as: 60 / step duration;

[0026] Pace is: distance / time between the start and end points;

[0027] Stride speed is: left or right foot stride distance / stride time;

[0028] Swing speed is: foot swing distance / swing time;

[0029] Turn duration is the time from the start to the end of the turning action.

[0030] Preferably, in the gait collection module, the unified multiple system atrophy assessment method is used to assess the severity of the participants' disease, and the Montreal Cognitive Assessment method is used to assess the participants' overall cognitive function.

[0031] In the present invention, the purpose of evaluating the severity of the participant's disease is to clarify the patient's disease stage and ensure the generalizability of the system; the purpose of evaluating the participant's overall cognitive function is to eliminate the patient's cognitive impairment and ensure that the patient has basic cognitive ability to understand instructions.

[0032] 2. Gait Analysis Module

[0033] In the present invention, the gait analysis module is used to analyze the differences in single-task and dual-task gait between patients with multiple system atrophy (MSA) and healthy subjects, so as to calculate the dual-task cost.

[0034] Preferably, in the gait analysis module, for the turning duration and double support period, the dual-task cost is: the dual-task gait index minus the single-task gait index;

[0035] For swing period, stride length, stride height, stride frequency, stride speed, stride velocity, and swing velocity, the dual-task cost is: single-task gait index minus dual-task gait index.

[0036] In the present invention, dual-task cost refers to the additional cognitive and motor control costs that patients need to pay when performing dual tasks compared to single tasks, which is reflected in the decline in performance in dual tasks. After unified calculation, the larger the value, the higher the dual-task cost.

[0037] 3. Magnetic Resonance Imaging Module

[0038] Preferably, the magnetic resonance imaging module is a magnetic resonance imaging scanner, which is equipped with a 32-channel head coil and uses a volumetric three-dimensional spoiled gradient recall sequence to acquire T1-weighted images with the following parameters: repetition time TR = 2300 ms, echo time TE = 2.01 ms, flip angle FA = 8°, field of view FOV = 256 × 256 mm², slice thickness = 1 mm, no slice gap, voxel size = 1.0 × 1.0 × 1.0 mm³, number of slices = 192;

[0039] MRI data were acquired using an echo-planar imaging sequence with the following parameters: repetition time (TR) = 5100 ms, echo time (TE) = 72 ms, field of view (FOV) = 256 × 256 mm², diffusion-sensitive gradient field parameter b-values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion directions = 64, slice thickness = 2 mm, no interslice gap, and number of slices = 76.

[0040] In the present invention, both patients with Parkinson's disease and healthy subjects undergo magnetic resonance imaging (MRI). MRI is performed immediately after the subjects perform single-task and dual-task gait, thereby facilitating subsequent analysis of the correlation between dual-task costs and brain microlesions.

[0041] 4. Morphological Analysis Module

[0042] Preferably, the morphological analysis of the morphological analysis module includes the following steps:

[0043] A1. Orient the T1-weighted image in the MRI data in the LPI direction, and set the image origin to the anterior commissure;

[0044] A2. Visual inspection of MRI data for artifacts, followed by separation of cerebellum and brainstem structures from surrounding tissue;

[0045] A3. Visual inspection and correction of the separated cerebellum and brainstem structures;

[0046] A4. Spatially normalize and slice the corrected cerebellum and brainstem structures to obtain map slices and generate cerebellum and brainstem gray matter probability maps. During the generation, the normalized volume changes are modulated by using the retention option.

[0047] A5. Set the map slices to the Montreal Neurological Institute space and use a slight smoothing kernel to maintain the spatial accuracy of the infratentorial area to obtain the registered gray matter probability map.

[0048] In the present invention, step A4 is to obtain a unique image of each brain (each person's head is large or small); step A5 is to register all brains to the same standard brain through mathematical methods to ensure that the brains can be directly compared.

[0049] Preferably, the morphological analysis of the morphological analysis module includes:

[0050] The gray matter volumes of patients with multiple system atrophy (MSA) and healthy controls were compared using the registered gray matter probability maps using a two-sample t-test with sex and age as covariates.

[0051] Voxel-wise linear regression model I was used to analyze the relationship between cerebellar and brainstem infratentorial gray matter volumes and dual-task cost in patients with multiple system atrophy (MSA) with adjustment for sex and age.

[0052] In the present invention, the purpose of performing voxel-based morphometric analysis is to analyze the brain gray matter volume damage associated with dual-task cost.

[0053] Preferably, in the morphological analysis of the morphological analysis module, the gray matter volume of the Parkinson's disease multiple system atrophy patient group is reduced compared with the healthy control group.

[0054] 5. Diffusion Tensor Imaging Analysis Module

[0055] Preferably, the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module includes:

[0056] Diffusion tensor imaging was used to analyze the correlation between the dual-task cost of counter-count dual-task gait and the infratentorial white matter structures of the cerebellum and brainstem.

[0057] Diffusion tensor imaging was used to analyze the dual-task cost of spontaneous animal-named dual-task gait and its correlation with infratentorial white matter structures in the cerebellum and brainstem.

[0058] Preferably, the diffusion tensor imaging (DTI) analysis of the diffusion tensor imaging analysis module includes the following steps:

[0059] B1. Preprocessing: The MRI data were corrected for head motion and eddy current using the eddy correct command, and each diffusion-weighted image was aligned with the first b=0 image using the anisotropic alignment method.

[0060] B2. Feature extraction: A linear model is used to calculate the diffusion tensor of the preprocessed MRI data to generate a whole-brain white matter feature map of fractional anisotropy, axial diffusion coefficient, mean diffusion coefficient, and radial diffusion coefficient;

[0061] B3. Normalization to the infratentorial template: The whole-brain atlas is registered to each individual's T1-weighted image, and the cerebellum and brainstem are separated, spatially normalized, and re-sliced ​​to the SUIT template to obtain white matter feature maps of the cerebellum and brainstem infratentorial structures;

[0062] B4. Correlation between dual-task cost and infratentorial white matter features: A voxel-based linear regression model II was constructed. The white matter feature maps of the cerebellum and brainstem infratentorial structures and the dual-task cost were input into the linear regression model II to calculate the association between the infratentorial white matter features of the cerebellum and brainstem and the dual-task cost.

[0063] In linear regression model II, the threshold was set at voxel-level p1 < 0.001, and the standard SUIT atlas was used as a mask for cluster-level FWE correction, with a threshold of p2 < 0.05 after correction. The Duvernoy human brainstem and cerebellum atlas was used to determine the location of the significant difference clusters on the SUIT brainstem template.

[0064] In the present invention, the purpose of performing correlation analysis using the diffusion tensor imaging analysis module is to analyze white matter damage associated with dual-task costs.

[0065] Preferably, in the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module, the dual-task cost of DTI analysis DTG-BC is:

[0066] Increased MD in the left MLR and SCP was associated with increased dual-task costs during the right sway cycle;

[0067] Increased MD, AD, and RD in left lobules IV and V were associated with higher dual-task costs of turn duration;

[0068] MD of right lobule IV, lobule V, lobule VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost of left sway velocity;

[0069] Increased MD in right lobule IV, V, VI, right SCP, right ECu, and right MRt was associated with increased dual-task cost of right sway velocity;

[0070] In the diffusion tensor imaging analysis of the diffusion tensor imaging analysis module, the dual-task cost of DTG-SAN for DTI analysis is:

[0071] Increased MD in right lobule IV, V, VI, right SCP, right ECu, and right MRt was associated with increased dual-task costs of left sway velocity;

[0072] Increased MD in right lobule IV, V, VI, SCP, Ecu, and MRt was associated with increased dual-task cost of right sway velocity;

[0073] MSA-P: multiple system atrophy with parkinsonism; DTI: diffusion tensor imaging; DTG-BC: dual-task gait with backward counting; DTG-SAN: dual-task gait with spontaneous animal naming; MNI: Montreal Neurological Institute space; MD: mean diffusivity; RD: radial diffusivity; AD: axial diffusivity; MLR: midbrain motor area; SCP: superior cerebellar peduncle; ECu: lateral cuneate nucleus; MRt: medullary reticular formation.

[0074] Beneficial effects of the present invention:

[0075] 1. The system of the present invention can be used to determine the differences in single-task and dual-task gait between patients with Parkinson's disease and healthy controls, and the relationship between dual-task costs and infratentorial structures, including the correlation between dual-task costs and microscopic damage to the white and gray matter of the brains of patients with Parkinson's disease. This helps medical staff explore the infratentorial structures of the brain and fills a gap in previous technologies.

[0076] 2. The system of the present invention can be used to describe the basic characteristics of dual-task gait performance in patients with Parkinson's disease and to elucidate the potential neural mechanisms of dual-task cost. BRIEF DESCRIPTION OF THE DRAWINGS

[0077] Figure 1 Schematic diagram of the system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease and multiple system atrophy in this invention;

[0078] Figure 2 This is a picture after morphological analysis of an embodiment of the present invention;

[0079] Figure 3This is a DTI analysis image of the dual-task cost of the reverse-counted dual-task gait in MSA-P according to an embodiment of the present invention;

[0080] Figure 4 This is a DTI analysis image of the dual-task cost of spontaneous animal-named dual-task gait in MSA-P according to an embodiment of the present invention. DETAILED DESCRIPTION

[0081] The following will provide a clear and complete description of the concept, specific structure and technical effects of the present invention in conjunction with the embodiments and drawings, so as to fully understand the purpose, features and effects of the present invention.

[0082] Example 1

[0083] Analyze dual-task costs and brain micro-lesion systems in patients with Parkinson's disease Figure 1 Shown, including:

[0084] A gait acquisition module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the participant's gait feature data;

[0085] a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data;

[0086] an MRI module for acquiring MRI data of participants;

[0087] a morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task cost and the subtentorial gray matter of the brain;

[0088] The diffusion tensor imaging analysis module is connected to the magnetic resonance imaging module and the gait analysis module, and is used to perform diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the dual-task cost of the participants and the subtentorial white matter of the brain.

[0089] In the present invention, the gait acquisition module, gait analysis module, magnetic resonance imaging module, morphological analysis module, diffusion tensor imaging analysis module and other modules can all be executed using computers and other devices. Therefore, the system of the present invention can be applied in industry.

[0090] For example, the gait acquisition module can use the ReadyGo video gait measurement system developed by Beijing Chinese Academy of Sciences Ruiyi Information Technology Co., Ltd. for gait measurement and calculation. The gait analysis module can use statistical analysis software or a data analysis platform for analysis. The magnetic resonance imaging module can utilize an MRI scanner. The morphological analysis module can utilize Statistical Parametric Mapping Software version 12, MRIcron software, and statistical analysis software. The diffusion tensor imaging analysis module can utilize the FMRIB Diffusion Toolbox and the PANDA Toolbox.

[0091] Example 2

[0092] This embodiment further explains the gait acquisition module based on the embodiment 1.

[0093] The gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in single-task gait, dual-task gait with reverse counting, and dual-task gait with spontaneous animal naming, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the participant's disease severity and overall cognitive function based on the gait feature data.

[0094] In this example, in single-task gait (STG), participants walked back and forth three times on a 3-meter walkway at a fixed distance from a camera. In dual-task gait with counting backwards (DTG-BC), participants performed an additional task of counting backwards from 100 while walking. In dual-task gait with spontaneous animal naming (DTG-SAN), participants spontaneously named non-repeated animals while walking.

[0095] This embodiment uses the following indicators to represent gait characteristics: swing period, double support period, stride length, step height, cadence, pace, stride speed, swing speed, and turn duration. Compared with single-task gait, the dual-task gait has a longer turn duration and double support period, a shorter swing period, stride length, and step height, and a lower stride speed, cadence, pace, and swing speed, indicating a higher dual-task cost. For ease of understanding and calculation, the dual-task cost is represented by subtracting the single-task gait indicator from the dual-task gait indicator for the turn duration and double support period, and by subtracting the dual-task gait indicator from the single-task gait indicator for the swing period, stride length, stride speed, cadence, pace, swing speed, and step height. Therefore, the larger the final calculated value, the higher the dual-task cost.

[0096] In this embodiment, the unified multiple system atrophy rating scale was used to assess disease severity, and the Montreal cognitive assessment was used to assess overall cognitive function.

[0097] Example 3

[0098] This embodiment further explains the gait analysis module based on the embodiment 2.

[0099] This example included 20 patients with MSA-P and 10 healthy controls matched for age, sex, and education. The mean age of the MSA-P patients was 57.65 years, and the mean disease duration was 1.75 years. The mean score on the Unified Multiple System Atrophy Rating Scale Part II for MSA-P was 11.90, and the mean score on the Montreal Cognitive Assessment was 22.35. Three patients had normal gait, 16 had mild gait impairment, and one had moderate gait impairment.

[0100] Compared with healthy controls, MSA-P patients showed no differences in STG performance but showed significantly reduced right stride length in DTG-BC and DTG-SAN, and increased turn duration in DTG-BC. Furthermore, MSA-P patients showed greater dual-task costs in DTG-BC, as evidenced by changes in right sway period and turn duration in DTG-BC.

[0101] Example 4

[0102] This embodiment further explains the magnetic resonance imaging module based on the embodiment 3.

[0103] All MRI scans were performed on a 3.0 T MRI scanner equipped with a 32-channel head coil (MAGNETOM Skyra, Siemens Healthineers, Erlangen, Germany). T1-weighted images were acquired using a volumetric 3D spoiled gradient-recalled sequence with the following parameters: repetition time TR = 2300 ms, echo time TE = 2.01 ms, flip angle FA = 8°, field of view FOV = 256 × 256 mm², slice thickness = 1 mm, no interslice gap, voxel size = 1.0 × 1.0 × 1.0 mm³, and number of slices = 192.

[0104] The repetition time TR = 5100 ms, echo time TE = 72 ms, field of view FOV = 256 × 256 mm², diffusion-sensitive gradient field parameter b-values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion directions = 64, slice thickness = 2 mm, no interslice gap, and number of slices = 76 were used.

[0105] Example 5

[0106] This embodiment further explains the morphological analysis module based on the embodiment 4.

[0107] This example uses the Unbiased Template Toolbox for Infratentorial Space in Statistical Parametric Mapping software, version 12 (SPM12), to perform voxel-based morphometric analysis (VBM) of the cerebellum and brainstem. Prior to analysis, T1-weighted images were oriented in the LPI orientation, with the image origin set to the anterior commissure to optimize SUIT algorithm performance. After visual inspection for data artifacts, cerebellar and brainstem structures were isolated from surrounding tissue. Separation results were visually inspected and manually corrected using MRIcron software to ensure the exclusion of any non-brainstem or non-cerebellar tissue. Subsequent spatial normalization and slicing generated gray matter probability maps for the cerebellum and brainstem, modulated by volumetric changes after normalization using the "preserve" option. These maps were then sliced ​​into Montreal Neurological Institute (MNI) space using a lightly smoothed kernel (3 mm full-width at half-maximum) to maintain spatial accuracy of the infratentorial region.

[0108] Gray matter volume in the MSA-P group and healthy controls was compared using a two-sample t-test, with sex and age as covariates. Furthermore, a voxel-wise linear regression model adjusted for sex and age was used to explore the relationship between gray matter volume and dual-task cost in the MSA-P group. Statistical significance was set at p < 0.001 at the voxel level.

[0109] Morphological analysis results: This example found that the gray matter volume of the right parietal lobe (lobule IV and lobule V) of the anterior cerebellum of MSA-P patients was significantly reduced. Figure 2 However, linear regression analysis did not reveal any association between gray matter volume of the cerebellum / brainstem and dual-task costs.

[0110] Figure 2 Center, A: Gray matter volume is reduced in MSA-P patients compared with healthy controls.

[0111] Example 6

[0112] This embodiment further explains the diffusion tensor imaging analysis module based on the fifth embodiment.

[0113] The Diffusion Tensor Imaging Analysis module provides the following diffusion tensor imaging analysis:

[0114] Diffusion tensor imaging (DTI) was used to analyze the correlation between dual-task cost of dual-task counting-backward gait (DTG-BC) and infratentorial white matter structures in the cerebellum and brainstem.

[0115] Diffusion tensor imaging (DTI) was used to analyze the correlation between dual-task costs of spontaneous animal named dual-task gait (DTG-SAN) and infratentorial white matter structures in the cerebellum and brainstem.

[0116] In this embodiment, the specific method for preprocessing and analyzing magnetic resonance imaging data to obtain white matter features using the FMRIB diffusion toolbox and the PANDA toolbox in diffusion tensor imaging (DTI) is as follows:

[0117] B1 Preprocessing: The raw data were corrected for head motion and eddy currents using the eddy correct command, which applies an anisotropic alignment method to align each diffusion-weighted image with the first b = 0 image. This step aims to remove artifacts from the DTI data and prepare the data for subsequent feature extraction.

[0118] B2 Feature Extraction: A linear model is then used to calculate the diffusion tensor, generating whole-brain maps of fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD). FA reflects the directional preference for diffusion, with low FA values ​​often associated with tissue damage. MD indicates the degree of water molecule diffusion, while AD and RD indicate the degree of axial and radial diffusion, respectively. High MD, AD, and RD values ​​indicate increased diffusivity and are associated with tissue damage. The purpose of this step is to calculate white matter features, preparing for the subsequent extraction of corresponding white matter features of infratentorial structures.

[0119] B3 Normalization to the Infratentorial Template: These whole-brain atlases were then registered to each individual's T1-weighted images. The cerebellum and brainstem were then isolated, spatially normalized, and resliced ​​to the SUIT template based on parameters derived from the T1-weighted SUIT analysis. This process generated diffusion value atlases for the cerebellum and brainstem, which were spatially normalized in MNI space, preserving the original intensity (non-modulated). Images were smoothed using a 3 mm full-width at half-maximum kernel. The purpose of this step was to generate white matter feature maps of the infratentorial structures for subsequent analysis of the correlation between dual-task costs and white matter features of the infratentorial structures in the cerebellum and brainstem.

[0120] B4 Correlation between Dual-Task Cost and Infratentorial White Matter Features: A voxel-based linear regression model was constructed, again incorporating sex and age as covariates, to explore the association between DTI indices and dual-task cost in the MSA group. A voxel-level threshold of p < 0.001 was set, and cluster-level FWE correction was performed using the standard SUIT atlas as a mask, with a corrected threshold of p < 0.05. We used the Duvernoy human brainstem and cerebellum atlas to locate the locations of significant differential clusters on the SUIT brainstem template. The goal of this step was to identify white matter features and structural regions associated with dual-task cost.

[0121] 1. DTI analysis of the dual-task cost of DTG-BC

[0122] like Figure 3 As shown, it is a DTI analysis of the dual task cost of counting backwards and walking simultaneously in MSA-P patients. Figure 3 In:

[0123] A: Increased MD of the left MLR and SCP was associated with increased dual-task cost in the left turning duration (peak MNI coordinates: -6 -32 -18);

[0124] B, C, D: Increased MD (B), AD (C), and RD (D) of the left lobule IV and V were associated with increased dual-task cost in the turning duration (peak MNI coordinates: -23 -40 -30; -32 -40 -36; -33 -46 -35);

[0125] E: Increased MD of the right lobule IV, V, VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost in the left turning speed (peak MNI coordinates: 7 -41 -53);

[0126] F: Increased MD of the right lobule IV, V, VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost in the right turning speed (peak MNI coordinates: 7 -41 -53).

[0127] Abbreviations: MSA-P, Parkinson-plus syndrome; DTI, diffusion tensor imaging; MNI, Montreal Neurological Institute space; MD, mean diffusivity; RD, radial diffusivity; AD, axial diffusivity; MLR, midbrain motor area; SCP, superior cerebellar peduncle; ECu, external cuneate nucleus; MRt, medullary reticular formation.

[0128] The aforementioned MD (B), AD (C), and RD (D) are all indices of white matter.

[0129] 2. DTI analysis of dual-task cost in DTG-SAN

[0130] As shown in FIG. 2, it is a DTI analysis of dual-task cost in the dual-task gait of spontaneously naming animal names in MSA-P patients, Figure 4 In: Figure 4 A: Increased MD of the right lobule IV, V, VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost in the left turning speed (peak MNI: 5 -38 -48);

[0131] B: Increased MD of the right lobule IV, V, VI, right SCP, right ECu, and right MRt were associated with increased dual-task cost in the right turning speed (peak MNI: 5 -39 -53);

[0132]

[0133] ​Abbreviations: MSA-P: multiple system atrophy-parkinsonian type; DTI: diffusion tensor imaging; MNI: Montreal Neurological Institute space; MD: mean diffusivity; RD: radial diffusivity; AD: axial diffusivity; SCP: superior cerebellar peduncle; ECu: lateral cuneate nucleus; MRt: medullary reticular formation.

[0134] In summary, the results of the embodiment are: under STG conditions, there is no difference in gait indicators between MSA-P and HC. In DTG-BC, MSA-P patients showed higher dual-task costs, manifested as longer turning times and shorter swing cycles. Voxel-based morphometric analysis showed that MSA-P patients had reduced gray matter volume in the right IV and V lobules compared with HC. Diffusion tensor imaging analysis showed that in DTG-BC, higher dual-task costs of the right swing cycle were associated with higher mean diffusivity in the left midbrain motor area. In addition, in DTG-BC, higher dual-task costs of turning time were associated with increased mean diffusivity, axial diffusivity, and radial diffusivity in the white matter of the left IV and V lobules.

[0135] Conclusions: MSA-P patients have higher dual-task burden compared with HC, and abnormalities in dual-task cost in MSA-P may indicate infratentorial microstructural lesions, such as gray and white matter lesions.

[0136] In the future, the correlation between dual-task cost and the brain's infratentorial gray and white matter can be used to establish a dual-task cost prediction model, and the dual-task cost prediction model can be used to predict the lesions of the infratentorial microstructural gray and white matter in MSA-P patients.

[0137] The above is a detailed description of the embodiments of the present invention, but the present invention is not limited to the embodiments. Those skilled in the art may make various equivalent modifications or substitutions without departing from the spirit of the present invention. These equivalents or substitutions are all included in the scope defined by the claims of the present invention.

Claims

1. Analyze dual-task costs and brain micro-lesion systems in patients with Parkinson's disease, characterized by: include: A gait acquisition module is used to collect the single-task and dual-task gait data of the participant and process the gait data to obtain the participant's gait feature data; a gait analysis module, connected to the gait acquisition module, for analyzing the differences between the single-task and dual-task gaits of the participants and calculating the dual-task cost based on the gait feature data; an MRI module for acquiring MRI data of participants; a morphological analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing voxel-based morphological analysis on the magnetic resonance imaging data to analyze the correlation between the participants' dual-task cost and the subtentorial gray matter of the brain; a diffusion tensor imaging analysis module, connected to the magnetic resonance imaging module and the gait analysis module, for performing diffusion tensor imaging analysis on the magnetic resonance imaging data to analyze the correlation between the participant's dual-task cost and the infratentorial white matter of the brain; The morphological analysis of the morphological analysis module includes the following steps: A1. Orient the T1-weighted image in the MRI data in the LPI direction, and set the image origin to the anterior commissure; A2. Visual inspection of MRI data for artifacts, followed by separation of cerebellum and brainstem structures from surrounding tissue; A3. Visual inspection and correction of the separated cerebellum and brainstem structures; A4. Spatially normalize and slice the corrected cerebellum and brainstem structures to obtain map slices and generate cerebellum and brainstem gray matter probability maps. During the generation, the normalized volume changes are modulated by using the retention option. A5. Set the map slices to the Montreal Neurological Institute space and use a slight smoothing kernel to maintain the spatial accuracy of the infratentorial region to obtain the registered gray matter probability map; The morphological analysis of the morphological analysis module includes: The gray matter volumes of patients with multiple system atrophy (MSA) and healthy controls were compared using the registered gray matter probability maps using a two-sample t-test with sex and age as covariates. Voxel-wise linear regression model I was used to analyze the relationship between cerebellar and brainstem infratentorial gray matter volumes and dual-task cost in patients with multiple system atrophy (MSA) with adjustment for sex and age. The diffusion tensor imaging analysis module includes the following steps: B1. Preprocessing: The MRI data were corrected for head motion and eddy current using the eddy correct command. Anisotropic alignment was applied to align each diffusion-weighted image with the first b = 0 image, where b is the diffusion-sensitive gradient field parameter. B2. Feature extraction: A linear model is used to calculate the diffusion tensor of the preprocessed MRI data to generate a whole-brain white matter feature map of fractional anisotropy, axial diffusion coefficient, mean diffusion coefficient, and radial diffusion coefficient; B3. Normalization to the infratentorial template: The whole-brain atlas is registered to each individual's T1-weighted image, and the cerebellum and brainstem are separated, spatially normalized, and re-sliced ​​to the SUIT template to obtain white matter feature maps of the cerebellum and brainstem infratentorial structures; B4. Correlation between dual-task cost and infratentorial white matter features: A voxel-based linear regression model II was constructed. The white matter feature maps of the cerebellum and brainstem infratentorial structures and the dual-task cost were input into the linear regression model II to calculate the association between the infratentorial white matter features of the cerebellum and brainstem and the dual-task cost. In linear regression model II, the threshold was set at voxel-level p1 < 0.001, and the standard SUIT atlas was used as a mask for cluster-level FWE correction, with a threshold of p2 < 0.05 after correction. The Duvernoy human brainstem and cerebellum atlas was used to determine the location of the significantly different clusters on the SUIT brainstem template.

2. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease and multiple system atrophy according to claim 1, characterized in that: The gait acquisition module includes a video gait measurement system, which includes a camera and a processing terminal. The camera collects image data of the participant in single-task gait, dual-task gait with reverse counting, and dual-task gait with spontaneous animal naming, and sends the collected image data to the processing terminal. The processing terminal processes the image data to obtain gait feature data, and evaluates the participant's disease severity and overall cognitive function based on the gait feature data.

3. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease according to claim 2, characterized in that: In the gait acquisition module, the single-task gait includes: the participant walks back and forth three times on a 3-meter walkway at a fixed distance from the camera; The dual-task gait for backward counting includes: participants performing an additional task of counting backward from 100 while walking in front of a camera; The spontaneous animal naming dual-task gait includes an additional task in which participants spontaneously name non-repeated animals while walking in front of a camera.

4. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease according to claim 2, wherein: In the gait acquisition module, the gait characteristic data include: swing period, double support period, stride length, step height, step frequency, step speed, stride speed, swing speed and turn duration; In the gait analysis module, for the turn duration and double support period, the dual-task cost is: the dual-task gait index minus the single-task gait index; For swing period, stride length, stride height, stride frequency, stride speed, stride velocity, and swing velocity, the dual-task cost is: single-task gait index minus dual-task gait index.

5. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease and multiple system atrophy according to claim 2, characterized in that: In the gait collection module, the unified multiple system atrophy assessment method is used to assess the severity of the participants' disease, and the Montreal Cognitive Assessment method is used to assess the participants' overall cognitive function.

6. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease according to claim 1, characterized in that: The magnetic resonance imaging module is a magnetic resonance imaging scanner equipped with a 32-channel head coil, which uses a volumetric three-dimensional spoiled gradient recall sequence to acquire T1-weighted images, with the following parameters: repetition time TR = 2300 ms, echo time TE = 2.01 ms, flip angle FA = 8°, field of view FOV = 256 × 256 mm², slice thickness = 1 mm, no slice gap, voxel size = 1.0 × 1.0 × 1.0 mm³, and number of slices = 192; MRI data were acquired using an echo-planar imaging sequence with the following parameters: repetition time (TR) = 5100 ms, echo time (TE) = 72 ms, field of view (FOV) = 256 × 256 mm², diffusion-sensitive gradient field parameter b-values ​​of 0 and 1000 s / mm², voxel size = 2 × 2 × 2 mm³, diffusion directions = 64, slice thickness = 2 mm, no interslice gap, and number of slices = 76.

7. The system for analyzing dual-task costs and brain microlesions in patients with Parkinson's disease as claimed in claim 1, characterized in that: The Diffusion Tensor Imaging Analysis module provides the following diffusion tensor imaging analysis: Diffusion tensor imaging was used to analyze the correlation between the dual-task cost of counter-count dual-task gait and the infratentorial white matter structures of the cerebellum and brainstem. Diffusion tensor imaging was used to analyze the dual-task cost of spontaneous animal-named dual-task gait and its correlation with infratentorial white matter structures in the cerebellum and brainstem.

Images